Heroin special report: Counterattacking the epidemic in Rockford and the Rock River Valley

Saturday

Mar 22, 2014 at 8:00 AM

By Georgette Braunand Chris GreenRockford Register Star

ROCKFORD — As heroin takes a deadly toll on the Rock River Valley, there’s been little push for two life-saving measures: legally safe 911 calls and antidote distribution.

Lisa Knight, 25, knew it was time to get help when her friend turned blue on the kitchen floor of her upstairs apartment in southeast Rockford two weeks before Christmas.

She had met him two years earlier when they were in treatment for heroin abuse. Now, they were back to using the illegal, euphoria-producing depressant.

Heroin is the most dangerous and addictive of the main recreational drugs, and increasingly more popular. In Rockford and across the country, it’s killing more and more people. In Winnebago County last year, 51 heroin-related deaths were reported by the coroner, more than twice the number of homicides, which stood at 22 in 2013 in Rockford and four outside the city.

Knight’s friend was gurgling. She’d pounded on his chest, but he didn’t come to. Knight was afraid of calling 911. She had not supplied the heroin. Yet she still worried she’d be charged with drug-induced homicide if her friend died.

“I could have gone to jail,” she said. “I could have got a murder (charge).”

Knight asked her neighbor, a former drug user, to check the friend to determine whether they should call for emergency help. They called. Paramedics gave the overdose victim Narcan, the brand name for the opiate antidote naloxone, which can be injected into muscle or sprayed up the nose. It brought him back from the brink of death in a few minutes. He had turned blue from lack of oxygen, and at one point he “coded,” according to a Rockford Police Department report. That means his heart had stopped beating or he stopped breathing. He was taken to a hospital. Later, Knight said, the man checked into a substance abuse treatment program.

Neither he nor Knight was charged with drug crimes, though police found syringes her friend had used. And Knight produced syringes and a spoon she had used to dissolve heroin with water over a flame so she could inject it into her veins.

“It’s like 30 or 40 Vicodins hitting you all at once, and from the first time I did it, I wanted to feel like this every minute of every day,” she said, explaining her heroin addiction. She had hidden the drug paraphernalia under her bed after the call to 911.

In this case, the Good Samaritan law enacted in Illinois in 2012 worked. It protects friends, family members and the overdose victims themselves from prosecution for possessing a small amount of drugs or paraphernalia when they seek medical care, assuming none of the friends or family members supplied or injected the drugs. And paramedics arrived in the nick of time to administer Narcan.

Yet no programs are in place in the immediate Rockford area to encourage drug users to call 911 to report an overdose or to distribute naloxone to friends and family to administer to overdose victims, a practice that has been legal in Illinois since 2010. And officials of local substance abuse treatment and health operations aren’t planning to do so. For the most part, they say, naloxone distribution doesn’t jibe with their missions.

In fact, naloxone has not been distributed widely to drug users and their friends in the Rock River Valley since a health program on Seventh Street in Rockford was shut down three years ago.

‘Join us saving lives’

Sue Fiduccia, the Winnebago County coroner, has called the overdose death count here “astronomical.”

There were 124 last year — 51 attributed to heroin or a combination of heroin and cocaine, up significantly from 2005, when there were 37 overdose deaths.

Today, heroin is the drug of choice because it’s inexpensive, just $10 for a dose. That compares with $30 to $80 on the black market for an Oxycontin pill, one of the painkillers that often start addicts on the path to heroin. And Rockford is close to Chicago, where gangs there get the drug from distributors in Mexico.

But even with the record heroin death count here — and amid a 45 percent increase nationwide from 2006 to 2010, according to the most recently available data from the Drug Enforcement Administration — most Illinoisans remain unaware of the life-saving potential of the Good Samaritan law and the naloxone expansion law that allows members of the public to administer naloxone.

Kathleen Kane-Willis, director of the Illinois Consortium on Drug Policy, made that point in 2,500 letters sent in January to police departments, schools, treatment centers and other groups throughout the state letting them know about The Emergency Medical Services Access Act, also known as the Good Samaritan law, and the Overdose Prevention and Naloxone Expansion Law. Illinois is one of at least 17 states that allow the public to administer naloxone without legal jeopardy.

“Help us spread the word to your colleagues,” Kane-Willis said in the letter. “Join us saving lives!”

In Winnebago County, 83 percent of those who died of overdoses last year were male and 81 percent were white, coroner’s figures show.

Nationally, more than half of heroin-dependent persons will be dead before the age of 50, with the mean age of death being 30, and overdose is a common danger, according to findings from the Reed Hruby Heroin Prevention Project at the Robert Crown Center for Health Education in Hinsdale.

National epidemic

Recent celebrity deaths have called attention to the epidemic, which has top government officials weighing.

n Cory Monteith of television’s “Glee” died July 13 after consuming heroin and alcohol. Movie and Broadway actor Philip Seymour Hoffman died with a needle in his arm after overdosing on heroin and other substances Feb. 2 in New York City.

n In January, Vermont Gov. Peter Shumlin devoted his entire State of the State message to what he said was “a full-blown heroin crisis” gripping the state.

n A study by the Centers for Disease Control and Prevention shows drug overdose is the leading cause of sudden death in the U.S., surpassing homicide, gunshots, suicide and car accidents. In 2010, the most recent year for which figures are available, 38,329 people died from drug overdoses in the U.S., with prescription drugs accounting for 60 percent of the deaths.

n A quarter of those who try heroin become addicted, according to the Robert Crown Center.

n Last year, 70 percent of those in Rockford-based Rosecrance Health Network’s young men’s unit had a primary diagnosis of opiate abuse, and a majority were there for heroin use. That’s up from 54 percent in 2011.

Heroin is derived from morphine, which is obtained from the opium poppy. It comes in a white to dark brown powder or tar-like substance. A heroin high can last three to four hours. An overdose becomes apparent immediately to three hours after the drug is taken.

Antidote not freely distributed here

The Total Health Awareness Team, which operated on Seventh Street and was the place to get naloxone in Rockford, was shut down by the city in 2011 for building code violations.

Dan Bigg, executive director of the Chicago Recovery Alliance, said THAT, which also offered a needle exchange program, had distributed “well over” 1,000 naloxone kits at no cost to heroin users, friends and family members.

The alliance occasionally comes to town to distribute the medicine at no cost to users and their loved ones. It costs the alliance $2 for the kits they distribute. A kit contains three syringes and two or three vials of naloxone, because one dose these days often isn’t enough to combat today’s stronger heroin. The giveaway program is financed with private donations.

At Walgreens with a prescription and no health care insurance, the Narcan brand can cost $22.99 per syringe and $31.99 per 0.4 mg/ml vial of naloxone, Walgreens spokesman Phil Caruso said. Bigg said the alliance distributes that dosage half the time and vials with 10 times that amount the other half.

Yet representatives of Rockford’s three hospitals say they are unaware of any doctors who prescribe Narcan.

Critics of Narcan distribution to the public believe Narcan is a crutch that enables opiate users to continue their drug use.

Bigg said that notion is incorrect. Opiate users don’t want to overdose; even if they are saved, an overdose can cause brain damage resulting from oxygen. deprivation “If they use it, they never want to use it again,” he said. “You almost die.”

John Gutenson, who delivers Narcan for the alliance, said opiate users don’t want to overdose because Narcan reverses the effects of their high, and the money and time they spent getting their dope is wasted.

The medicine, which paramedics have used for four decades, cannot be used to get high and is not addictive. It can reverse a heroin overdose in one to three minutes, but it has no effect on someone who doesn’t have an opiate in his system.

Naloxone has been credited with 10,000 overdose reversals since 1996, based on 53,000 kits being handed out through distribution centers, according to the U.S. Centers for Disease Control and Prevention. In 2010, 190 overdose prevention programs were providing naloxone. A 2013 study on Massachusetts’ naloxone distribution programs reported a 27 percent to 46 percent reduction in overdose deaths in cities with a distribution center.

In Rockford, Fire Department paramedics used Narcan 600 times in 2013. Narcan blocks brain receptors that opiates latch onto and helps the body remember to take in air.

Programs that draw heroin users are not always welcome, though.

“A lot of people are afraid that if you build it, they will come, and they don’t want a bunch of addicts hanging around,” Paul Doucette, police chief in Bennington, Vt., said in a March 5 story in The New York Times. “I hate to say it, but guess what? We already have them.” The story’s headline: “Heroin Scourge Overtakes a ‘Quaint’ Vermont Town.”

- Remedies Renewing Lives cites unknown variables and incomplete research as reasons it won’t prescribe Narcan, said Jane Armitage, vice president of development for the agency, which operates a methadone maintenance program in Rockford.

Of the 143 people currently enrolled in methadone treatment at Remedies,at least four out of five are former heroin users. Methadone is used as a substitute drug in the treatment of morphine and heroin addiction.

- Rosecrance, which served 6,319 adults and adolescents in substance abuse programs last year, keeps Narcan on hand for emergencies only. Rosecrance will connect families and individuals upon discharge with groups that provide Narcan if they ask, said Mary Ann Abate, vice president of public policy.

- Winnebago County Health Department Administrator Mike Bacon said administering naloxone should be restricted to frontline responders, but he is not ready to propose that the Health Department start distributing Narcan to the public. “It’s certainly a tool,” he said. “It’s something that needs to be looked at from a policy standpoint.”

- Shelton Kay, director of community services for Crusader Community Health, said Crusader would be interested in hosting a naloxone training session, but he doubts the clinic would distribute Narcan. “Our basic emphasis is primary care,” he said.

- Lt. Pat Hoey of the Rockford Police Department said officers here won’t be trained to administer Narcan because paramedics arrive at overdose calls before police officers, and they administer it.

- Dominic Iasparro, deputy chief of the Winnebago County Sheriff’s Department, said the sheriff’s office may consider having police carry and administer Narcan.

DuPage County deputies and officers in several other police departments in the county, including Bartlett, Hinsdale and Wood Dale, this year started carrying and administering Narcan. Narcan is made available through the DuPage County Health Department.

- Bigg, of the Chicago Recovery Alliance, said he plans to talk with officials of the Winnebago County Jail so that at least “no one leaves without knowledge of naloxone.” The U.S. Department of Health & Human Services’s Substance Abuse and Mental Health Services Administration recommends that jailers consider having naloxone prescribed to those released from incarceration who have used opioids in the past. That presumes their tolerance to drugs would be reduced. It also recommends hospitals consider prescribing Narcan for those discharged from emergency medical care following opioid overdose.

Most anyone can be trained to use Narcan — even the injectable form — in less than 15 minutes, said Cassandra Wingert, executive director of Wake the Nation, which offers training sessions and Narcan distribution in Chicago collar counties at places including libraries. She said Wake the Nation prefers to train in an hourlong session that includes information about the science of drug addiction.

Parents advocate to save lives

Terese Peterson of Rockford didn’t know she could have had Narcan on hand when she and her husband found their son, Nathan Peterson, now 20, unconscious Sept. 21, 2012, in the basement of their home.

“We were at a football game, came home and found him on the couch, not breathing,” she said. Paramedics administered two doses of Narcan to reverse the heroin overdose.

Nathan now lives in Madison, Wis., at the Chris Farley House, a treatment facility and halfway house. Terese said she would get the overdose antidote to keep at the family’s home.

“If I knew if he was coming home, I would, to save his life,” she said.

Nathan was fortunate that his parents came home when they did and he wasn’t elsewhere among drug users who may have hesitated to call 911 because they were unaware of the Good Samaritan law.

Terese said she became aware of the Good Samaritan law only a few months ago.

“There should be more education for parents and the general public,” she said.

Marilee Murphy Odendahl’s son, Ian Murphy Mitchard, died in 2007 on his 28th birthday of a heroin overdose in Chicago.

She believes he didn’t die alone. His body was found in a neighborhood where he had friends. No one gave him Narcan after his overdose, and he died before the Good Samaritan law was enacted. She has become certified to train others how to administer Narcan.

Murphy Odendahl said heroin use continues to be highly stigmatized.

“People often assume it is a moral or character failing,” she said. “But research is confirming it is a disease.”

The stigma is lessening, though, she said, as a result of public attention to recent celebrity deaths and the surge of deaths from heroin.

“I do feel more empowered,” said Murphy Odendahl, who belongs to several national harm-reduction groups.

Bonnie Falzone-Capriola of Rockford is feeling more empowered, too. She told state legislators at a hearing at Rock Valley College on March 1 that she’d like the state to consider funding the group she helped found last year with other parents — Hope Over Addiction. The group educates teens and is considering bringing a Narcan program to Rockford.

“The ultimate goal is not to die,” she said.

Her son, Barry Falzone, died of a heroin overdose in 2011. He was 25 years old and bipolar.

It was Falzone’s fourth overdose since he started using in 2007. He was alone in his Rockford home.

During one period when he was sober — he’d been in and out of substance abuse treatment programs and in jail on drug-related charges — Falzone wrote a letter to his mom.

“Mom, I know it’s hard to watch your son kill himself,” he said. “But please remember the threshold of pain I endure. When the day comes that I breathe my last breath, remember Mom, I’m resting finally; the peace I was always trying to taste. I look forward to the day I die.”